title: Early recognition of anti-N-methyl D-aspartate (NMDA) receptor encephalitis presenting as acute psychosis.
abstract: OBJECTIVE
  We present a case of anti-N-methyl D-aspartate (NMDA) receptor encephalitis that illustrates the dilemma that psychiatrists face in evaluating patients with first episode psychosis.
  
  
  CONCLUSIONS
  The discovery that acute psychosis can be the presenting feature of autoimmune encephalitis (in particular encephalitis caused by anti-NMDA receptor antibodies) has both practical and theoretical consequences. First, this condition is an important, but often overlooked, differential diagnosis of first episode psychosis. Antibody testing is not currently part of routine screening, though delayed (or missed) diagnosis can lead to prolonged hospital stay, medical complications and incomplete or delayed recovery. Widespread screening of patients with first presentation psychosis for anti-NMDA receptor and anti-voltage-gated potassium channel (anti-VGKC) antibodies is warranted for a number of reasons: to expedite appropriate treatment, to determine the true proportion of patients with these conditions presenting as psychosis, and to help elucidate the neurochemical causes of psychosis.
authors.affiliation: Medical Intern, Royal Adelaide Hospital, Adelaide, SA, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Tidswell
authors.forename: Timothy
authors.initials: T
authors.lastname: Kleinig
authors.forename: David
authors.initials: D
authors.lastname: Ash
authors.forename: Philip
authors.initials: P
authors.lastname: Thompson
authors.forename: Cherrie
authors.initials: C
authors.lastname: Galletly
mesh_terms: D000328:Adult; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011618:Psychotic Disorders / Q000175:diagnosis*; D012559:Schizophrenia / Q000209:etiology
keywords: anti-N-methyl D-aspartate receptor encephalitis; first episode psychosis